Episode 14: Tampon Taboo

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia Podcast. I'm an ObGyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we will talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Hi everyone. It's me, Dr. Sophia, and welcome to the Dr. Sophia Podcast. On today's podcast, we are gonna be talking about tampons. As always, I'm joined with my good friend and co-host, Touseef Mirza.

Touseef Mirza:
Hi, everybody. So yes, we are gonna be talking about tampons.

Dr. Sophia:
Tampons, tampons, tampons.

Touseef Mirza:
Yes. And tampon taboo. We called it that way because tampon gets a bad rap. And so we wanted to talk about, not just about the tampon, but why it, it gets that, that negative connotation. So we're just going to be looking at different aspects of the tampon. So, I guess the first, before even talking about like, you know, what we think about tampons or our experience with it, what is actually a tampon? How would you describe that?

Dr. Sophia:
It is a small ball of cotton. It's very tightly wound, and you place into the vagina during the time of menses in order to collect menstrual blood. And as the blood flows, it then expands and holds onto the blood. And really what it's doing is because it's there, it blocks or stops the blood from getting all the way down so that you don't have a whole messy scene , so to speak. But yeah, no, the point of the tampon is to collect menstrual blood in a more, I guess, discreet way, perhaps.

Dr. Sophia:
Basically, the blood is not even coming out of your vagina.
It doesn't really come out of your vagina for the most part. Right. and then it's only when you remove the tampon do you remove the tampon with the blood that's collected in it, and then you would then put in a new one or, you know, what have you during the time of your menstrual cycle, during, I mean, of the blood flow during your period.

Touseef Mirza:
So, when was the first time that you found out about the tampon or had an experience with the tampon?

Dr. Sophia:
Oh my God. So here I am, me, the ObGyn. Okay. I was 10.
And oddly enough, I actually went to a male friend's house. I went to use the bathroom. We'd been like doing our homework or what have you. And I went to use the bathroom, and I saw this box in the bathroom, and I was like, oh, what is this thing? And so I, okay, I hate to say this, but like, I stole one.

Touseef Mirza:
You just took one, you opened the box and just took it.

Dr. Sophia:
I just, I just opened the box and I took it because I was like, what is this thing? ? And I remembered like, bringing it home and, you know, being all secretive, going into my bathroom to try to open it and then figure out what it was because I'd gone on a school trip and someone had mentioned the word or the concept of a tampon.

Dr. Sophia:
And so when I saw it at my friend's house in his bathroom, because his mother used tampons, I really wanted to know what it was. So

Touseef Mirza:
You knew it was a tampon?

Dr. Sophia:
I'd heard the word.

Touseef Mirza:
And you probably saw it like written on the

Dr. Sophia:
Box or something, and I saw it on the box.

Touseef Mirza:
Got it.
So then you went home, you did the dissection, and what was your impression?

Dr. Sophia:
So it was a Tampax brand, first of all. Okay. And it had an applicator, it was a cardboard box applicator. Yeah. And then, so I was like, okay, now that I've got, I, I open it up, I see the board, the board thing, and I'm still like, I'm totally confused. I don't know what the hell is that about. And then the applicator has a way you can push up. So you have to push up the tampon through the board, which all makes sense, of course. Now to me. in order to dislodge the tampon into the vagina. So you use the applicator as an introducer? to introduce the tampon into the vagina, and then you push it up into the vagina, but, okay. But I didn't know any of this as a child. Right. And I opened the thing up and I, I was like, what the hell is this thing? What's the point? And then of course, I put it in a thing of water. I tried to like flush it, and I got all scared because I was like, oh, it's gonna definitely, it's gonna mess up the toilet. It's gonna get stuck. The thing expanded. I didn't understand . Oh, it was a mess. It was a complete, like, and, and I didn't ask anyone. I wouldn't dare ask my mother what the heck it was. I was just too nervous about getting in trouble.

Touseef Mirza:
So the taboo was already working on you?

Dr. Sophia:
So I had tampon taboo from the-
Touseef Mirza:
Get-go

Dr. Sophia:
From 10. There's my story. Yeah.

Touseef Mirza:
I actually, I don't remember like the first time I encountered the tampon, like having a conversation about tampon. But I remember, remember that when I was 13, I had started my menstruation maybe, maybe the year before or that year, and I had to go swimming. And so it's a little, hazy, but I didn't know how it came to be. But anyways, I had tampons in the bathroom, I think that my mom bought for me. I think I stayed in that bathroom for an hour and a half because I just didn't know what to do. And so, my mom never used the tampon in, in her life, and she was just like, well, you know, just read the instruction. But then you open up and you look at the diagram and it looked like an alien or something that was like, drawn up. I had no idea what the drawing was trying to communicate , you know, like, what, what is that? Is that a bum? Is that, you know, which, which is the front? Which is, I mean, it was just so confusing because I don't know how, you know, anatomically a vagina looks, so I have no clue. And so I, I finally, and it was so scary to insert something inside of me that was so mysterious. Like, that place is so mysterious for women because we don't see it, you know?

Dr. Sophia:
That's true. That's true.

Touseef Mirza:
And you have to push it inside of something you've never seen. And for some, and for many actually have never even felt.

Touseef Mirza:
Exactly. So now, not only am I like figuring out stuff down there, but then I have to insert in a way. And I remember I was, and you have to leave it there, and then I have to leave it there. And I didn't understand. Mine was a plastic applicator. I said, okay, but I don't understand, like, how, so the plastic is not supposed to stay with me, but right now it's on top of the thing. And so I just push it and then it'll stain my hand. Like how, like, I just didn't understand that concept. I thought it was all gonna go in. As you can tell, this was like quite an ordeal. And so one of the biggest things also was what angle do I put it in? You know, do I put it in straight up, straight up almost horizontal, 30 degrees, 45 degrees.

Touseef Mirza:
And so I tried different ways. I didn't push it all the way through, but I was trying to see, you know, where there was a little bit of a more, I guess, facility for it to happen. And I remember at a certain point I said, oh, now it's going. But I was mortified. I was just like, oh my God, it's actually in like, that concept. I was just like, it's in me. And so put it in. And then the applicator, when I pushed it through, magically stayed in my hand. I had no idea. And then there was only a string left. And then, and then I got scared because I pulled a little bit on, I think, oh no, maybe it's gonna be stuck there forever. 'cause I put it too far. now . Now there was another problem. I was like, oh, no, now what am I going to do? And I was just like, you know what? It's in, I gotta go swim swimming. Let's just hope the thing comes out later.

Dr. Sophia:
Oh my gosh.

Touseef Mirza:
It was really, it was really, it was really scary. So that was my first experience. It wasn't really great. And yes, it did come out; I don't remember that part. I just remember the traumatizing part at the beginning of doing this.

But I wanna talk a little bit about this because it's true, you know, boys, when they're growing up, they see their penis and everything; we don't. We don't, we don't touch it. You know, they literally have to like, hold and to pee. Right. But we never, we, I mean, we wipe ourselves, but we don't really have to do anything when we pee. You know? It just happens. So we don't have a very intimate and personal connection to our vaginas, to our vagina.

Dr. Sophia:
Because the vagina is the tunnel. It's the tube; it's inside. All the things outside are the vulva. The lips, what we call the labia, and then the clitoris, those are all parts of your vulva, which we, you know, collectively call the whole thing the vagina. .
But the actual vagina is the tunnel, the tube, the hole. And going inside, like going towards your uterus, that goes towards your cervix and your uterus. Right.
So nonetheless, the concept of the tampon, you know, my experience, like I said, so I had that experience when I was 10. And then my next experience of thinking about a tampon was with my best friend from middle school. And I went to her house. And again, I saw the blue box and I was like, whoa!

Dr. Sophia:
I don't remember how old I was. Maybe I was 12. And for myself, I actually went through my first period, when I was 11. Woo. I can't believe I'm announcing that to the whole world, . But, you know, I was 11 and a half when I got my period. And I used pads. That was the conversation. It was never a thought in my mind the concept of using a tampon for under any circumstance, swimming, no swimming, running, you know, athlete, no athlete. It didn't make a difference. There was nowhere in my, you know, culture, like, in my, in terms of my, my family, my mom, my aunts, my cousins. I knew no one personally who actually used a tampon until I met this friend. And I went to her house and she used a tampon. And I thought it was crazy. And I was like, oh my God, you do this, you, where? Are you kidding me?

Touseef Mirza:
How old was she?

Dr. Sophia:
We were 12.

Touseef Mirza:
Oh, both of you were 12.

Dr. Sophia:
The thought process in my mind was like, she's doing something that's gonna hurt her. Like, you know, like this, this must be, how does she do this? You know, and why would she do it? And why? Like, oh, my, like this sounds, I don't know. I was like, you are completely mortified about the concept, but I still never asked anyone or really talked about it or tried to figure it out. And so it's not like we had the internet. And then that would be years, I mean, years before I would even think about it. And myself, I don't think I used a tampon until after I had my first child.

Touseef Mirza:
Are you serious?

Dr. Sophia:
I swear to God. I'm not kidding you.

Touseef Mirza:
So how old were you?

Dr. Sophia:
22 .

Touseef Mirza:
So you went, you, did you start med school at 22?

Dr. Sophia:
I started med school at 25, 26.

Touseef Mirza:
Okay. Wow. Okay. Wow. So I was really early then. I was 13.

Dr. Sophia:
Well, I don't, and let me tell you, it's interesting because now it doesn't seem weird at all. And I have young girls who come in and who've been using tampons or what have you. But the reality is, is that there's still a lot of questions around it or, or stigma around it. Oh my God, am I gonna lose my virginity? Because I tried using a tampon. And that's a real question. And it brings me to another story as since I've been in ObGyn I had an actual patient who was having what we call contact dermatitis. She was having an irritation that was happening every month. And I said, it's the pads you're using during your period.

Touseef Mirza:
So where was the irritation

Dr. Sophia:
It was on her the outside lips, on the labia of her vagina. And I said, you are allergic to the pads you're using. Have you ever thought about using a tampon? . And her reaction, it brought me back to this, this conversation that we're having. And me, the 12-year-old was like, oh my God, where does that go? What are you doing? What are you thinking? What are you saying? How can this be? Where, what are you asking me to do? Was the look on her face? And I said, it's gonna be okay. I'm telling you it's gonna be okay. And this is a woman, I wanna say she must have been like 27 or 28 years old. This was gonna be the first time that she uses a tampon. And she said, but doctor, I really feel uncomfortable. "I've never tried this before. And it's not because she's never even, it's not even to say that this was a virgin . It's not a woman who'd never had sex before, but still felt very uncomfortable inserting the tampon. And I said, come back and I'll show you how to do it.

Dr. Sophia:
And that's exactly what we did. She came back. I said, I'm here, we're gonna talk about it. I want you to feel all of your parts and know that this is okay. And then we went through the process of how to insert the tampon and the string and how it comes out and, and all of the things. But I felt a sense of really like, like a sister, you know, going through that with her. And it was a feeling that I wish I had, I wish somebody had actually said, okay, I'm gonna walk you through this process. So I'm really excited about this topic.

Touseef Mirza:
I think that we're kinda kind of left to our own devices. And it's such a mysterious place when you're 13 down there, so you don't really know what to expect. And so that's why it's scary.

Dr. Sophia:
Yes. And I think actually, you know, especially for women, well, many women I should say, don't necessarily, you know, like to touch their bodies or get comfortable with their bodies and all of their parts. And perhaps you, they've never masturbated or, you know, done things to really understand their genitalia. And so the introduction of a tampon can be quite jarring. Like I said, in my family, I didn't know anyone who used it. My mom certainly never, probably never used a tampon in her life. And, you know, we're talking about a woman who's a, you know, of Haitian descent, you know, she came not just descent, she's came straight from Haiti to this country.

Touseef Mirza:
So that's part of the thing in terms of the taboo, is that it's, some of it is cultural that it's less accepted culturally in, in different societies.

Dr. Sophia:
Parts of the world, yes.

Touseef Mirza:
And then also it can be also from a religious perspective.

Dr. Sophia:
Definitely.

Touseef Mirza:
Because people might think it's obscene and also from a virginity perspective, and losing your hymen.

Dr. Sophia:
So that somehow it's breaking your hymen or that it makes you all of a sudden no longer a virgin because you've inserted something into your vagina.

Touseef Mirza:
So let's talk about that.

Dr. Sophia:
So let's talk about it. No, absolutely not. Your, your virginity has to do with you and a partner or a person that you first have intercourse with. That is the concept of losing your virginity. It's the whole concept of intercourse. And so inserting a, a tampon does not make you no longer a virgin. That's two separate things.

Touseef Mirza:
So what about the thinking that it's breaking the hymen.

Dr. Sophia:
The breaking of the hymen can happen so many ways, so many times. So the amount of 12, 13, 10 year olds, 9 year olds, 5 year olds, 20 year olds that I have seen in the ER because they had a bike accident. They were doing gymnastics and fell on the beam or injured themselves because of whatever the accident that may have or could have impaired or impacted their vagina is enormous. Okay. There have been, so, there just so many ways in which a woman, a girl, a young lady, can actually disrupt the hymen that has nothing, absolutely nothing to do with sex. And so that concept of losing your virginity and that equaling the hymen is so false. And it’s why, I mean, imagine that in some cultures that if a woman doesn't bleed when she has, you know, she has to have proof that she was a virgin. And the only way to prove that is to have bled, you know, because of quote unquote breaking the hymen after intercourse. And that doesn't always happen. First of all, the vagina is elastic, and it can be that a woman is a virgin, but her vagina is more accommodating. And so therefore there's no, the, the hymen doesn't necessarily break.

Touseef Mirza:
Where is the hymen exactly?

Dr. Sophia:
The hymen is the folds of the vagina, at the very entrance of the vagina, what we call the introitus. I wish I wasn't just on audio so that I could give you the visual, but if you just imagine putting your fingers together as if you were clasping them in front of you. And the hymen is just like leaves of the vaginal tissue that kind of fold in together. But there's definitely an opening and some give to that. That's why we are allowed to have menstruation passed through and things like that. And why a tampon can actually be placed inside of the vagina because those leaves or those edges of the vagina that form the hymen are malleable or can stretch.

Touseef Mirza:
So it's not that you're piercing through it, but it's elastic.

Dr. Sophia:
Yes, yes. It, I mean, it can be obviously a little bit more dense, especially in young women, young girls. But after you've passed through puberty , <affirmative> the vagina has a lot more elasticity and which makes sense because the body naturally is preparing itself for reproduction.

Touseef Mirza:
Okay. So let's talk about something else. Like, can a person be wearing a tampon, like even when they're sleeping, for example, like can they, can they just wear tampons and not wear pads and just wear tampons all the time?

Dr. Sophia:
Yes. Women can certainly just wear tampons if they have a menstrual flow that is not too heavy. . And so it is absorbed solely by the tampon. Then some women only wear tampons and they don't wear any like panty liners or pads along with it. They just wear their underwear. Okay. And then perhaps they may change their tampons more often so as not to have any accidents where, you know, there's a potential that you can leak around the tampon or if the tampon is too full. But just like a pad, you should be changing your tampon, you know, every couple of hours. I would say on average, most women probably change in a day, about four to six times a day.

Touseef Mirza:
Four to six times! Okay. I was doing it wrong then. I was maybe doing it twice a day.

Dr. Sophia:
We've evolved also so, you know, they have like the super absorbent and that includes both tampons and pads. But I would say on average, , you know, if a woman, I can gauge perhaps what their blood flow is, how heavy a period is, if they've changed their pads, let's say four times a day, or if they've changed their tampon about four times a day, to me, that's a average, normal flowing period. . Now if they tell me I've gotta use a tampon every hour because it's fully soaked or what have you, then that is alarming to me. And that lets me know that this is a woman who has a very heavy menstrual flow and we need to talk about it.

Touseef Mirza:
The thing that's tricky about tampons is because, you know, when you have a pad, you can see when it's time to change it because you see it. But it was always difficult to gauge. I, I'm pretty much menopausal now, so I don't really have periods and, and hence this is why I'm talking in the past tense,

Dr. Sophia:
So free to talk about it too.

Touseef Mirza:
Absolutely. But how do you really gauge the flow because you can't really feel it.

Dr. Sophia:
So, other interesting point about a tampon, and I think this is a very good point to make, that once it's in place inside of the vagina, you do not feel it. You do not feel it. You are able. And that's the reason why it's typically, you know, we women think about using a tampon for exercise or to go swimming or to, to do some activity where, if they're having their menstrual flow, that it doesn't get in the way of how they have to feel in their clothes or in the activity that they're doing with, let's say a pad. And so just having the tampon in place should not be uncomfortable. It should not hurt, it should not, cause any discomfort.

And when you take it out, typically it's going to have collected the menstrual flow and it expands a little bit sometimes, or is at least what we do expect to happen. And then it kind of slides out, you're able to, discard it and, and then that's it. But it's up to you as the person to kind of gauge what your flow is like. And sometimes that takes time to figure that out. , you know, knowing what your light days are, what your heavy days are. I would say on average, women really shouldn't go more than about four to six hours with a tampon in place.

Touseef Mirza:
Because I know there's different, I don't know if all brands are like that, but I know that there's different sizes, like depending if you have a heavy flow.

Dr. Sophia:
Like I said, it's definitely evolved over the years.

Touseef Mirza:
I don't think there was such a thing, but now you have like three, four sizes. Like is there a gauge of if it's, sorry if I'm being graphic, but if it's like fully soaked, does it mean that I should have taken it out before because it shouldn't be that way?

Dr. Sophia:
I think a good gauge is if you are having any leakage. Okay. It's probably a good gauge to know, okay, maybe I've left it in a little longer than I should have. Or maybe this is not the size tampon that I should be using based on the day of my, the flow that I'm having. Although most women, and I think this is appropriate, that they use like a panty liner along with their tampon, so that way the panty liner will then if they have any accidents or leakage or around the, the tampon, or it's too full and you don't, like you said, you don't necessarily feel it. , and you can't see it. At least you'll see evidence of it's probably time for me to change my tampon. Because you see the evidence of some leakage onto a panty liner or a pad, you have to know your body.

You have to know what's going on with your period. And that should be able to help you to understand if not, for some women, you know, they can be a little bit more nervous and say every single time they use the bathroom, they wanna change the same way that they do. They change their pads. I know women who, you know, every time they go to urinate, they change their pads just because they feel like it's more sanitary or that it's, you know, whether it's soaked or it's, or, or not. I do think that it's more comfortable, especially when it's coming out, if it it, if it does have some of the flow on it, because if Yeah, that's what I was gonna say. If the tampon is still very dry, then it can be a little bit uncomfortable when it has to come out.

Touseef Mirza:
That's what I was gonna say. If you take it out too soon, this is why you need to know your flow. It almost feels a little bit, not abrasive, but you feel it rubbing against the walls of the vagina. It's not a very good sensation. Is that bad for the inner wounds of the vagina when that happens?

Dr. Sophia:
I would say for the most part, no, because we have our own secretions and lubrication, around the vagina and the young vagina is elastic. you know, it has what we call rugae, and this is what estrogen is doing to our vagina. It's that major hormone that makes us women. And it works very well on the vagina in terms of lubrication and in terms of the elasticity of the vagina. And so our vaginas are meant to be able to, withstand even the putting in and out of a tampon, for example. And even if that tampon expands because of menstrual flow or if it expands or is dry when it's coming out, though, I will say that if it's too dry or gets stuck along the walls, you can have small abrasions that can happen on the vaginal walls because as it was coming out, it had made small tears in the, the walls or the lining of the vagina. So that is a real thing that can happen.

Touseef Mirza:
So in that same vein, since you said that the estrogen actually helps sort of the lubrication for women who are getting older, where you have less estrogen, and you have drier walls, then is that more of an issue with, with tampons? Well, mind you by that point, you're probably, maybe not menstruating.

Dr. Sophia:
But, you know something, remember perimenopausal women, they go through these, you know, long periods, you know, months at a time where they don't have a period, it could be 3, 4, 5 months and then all of a sudden they get a period or, the vaginal dryness can be there even while you're getting regular periods. And so the changes that are happening at the level of the vagina during perimenopause, you can experience a lot of those symptoms. The changes that the loss of the elasticity of the vagina and the dryness can be happening there. And so yes, it could make using tampons perhaps during that time a little bit more difficult.

Touseef Mirza:
And does it matter if, for example, you put the tampon in and maybe you didn't push it all the way that you usually do, like the placement of the tampon in the vagina.

Dr. Sophia:
That matters, and I'll tell you why. Because when the tampon is too low and it's near, let's say where your urethra is, it's going, that's where you have a lot more nerve endings and it's gonna feel a lot more, you may have some discomfort or you, you'll just feel, actually feel it there or at the level of the hymen, or what we call the introitus is where if the tampon is sitting there, then you will feel it. If the tampon is past that point, that's where inside of the vagina, you will not feel that the tampon is actually in place or is sitting there or in there.

And that would be the correct place. So you wanna get it past the point where you still feel it, you should not still feel the actual tampon inside of your vagina. And while we're talking about this, with the tampon being in place, it's so important that, you know, we, I know we said it a few minutes ago about the concept of how long it should be inside. Why is that important? Because you don't, you can put it in and literally forget it. That has happened. I've had women who've come to me and, you know, it's sometimes quite embarrassing for them because they come in to see me and they're like, oh, I'm here for my pap smear. Completely forgot that they left a tampon inside and they say, oh, Dr. Lubin, you know, I don't know. I have a little bit of a smell, or I have, you know, I don't know what's going on.

And they completely forget that three days ago they had their period and there may be a pair a, a tampon there, and they can't see the, they can't see the string. They may not see the string or the string is short or it's coiled up inside of the vagina. And so these things happen, and I'm happy at the times when they come in and I'm able to take it out and, and we, and all is fine, but it can lead to a very, very serious condition called toxic shock syndrome. When the tampon is left in place for too long. The toxic shock syndrome is a bacteria actually that is normally on all of our skin, but when left with all of the nutrients and the juices of the blood
that's there, and it's just sitting there for hours and hours and hours or even days on end can lead to this, very, very serious illness. The bacteria comes from the toxic shock. It's staph. It's a staphylococcus that is, and that can come from our skin. It comes from our skin staph is actually, it's part of what we call our normal flora. It's, it lives all over our bodies.

Touseef Mirza:
So it's inside the vagina. It just naturally lives inside the vagina.

Dr. Sophia:
It can be inside of the vagina.

Touseef Mirza:
And so when you have a tampon, is it because of the fibers of the tampon that enables the staph to…

Dr. Sophia:
It's not necessarily because of the fibers, though. It could be just because the fibers allow the blood and everything obviously to sit there and stay there. But moreover, it's just timing. . It's really more of a, of a time issue. And there are also different types of staph . And it's the release of the toxin. So it's when the staph has multiplied to a critical point where it then releases this toxin that then causes the toxic shock syndrome. so yes, in our vaginas, we have to remember we have a multitude of bacteria actually, and it's part of what we call normal flora, meaning all of these little bacterias that actually help keep the vagina healthy are in competition with each other, and they keep each other in check. . But under the right circumstances then, you know, a bacteria is allowed to overgrow.

Dr. Sophia:
And in this particular case, we're talking about staph. . Now staph is not something that's necessarily in large numbers in the vagina and actually is more on the skin or on the surface. So it, it's probably actually really coming from, it gets introduced inside of the vagina as you're placing your tampon. But nonetheless, it's not because it can't be in the vagina, it's just the fact that if it's allowed to overgrow in a, to a critical point . And when you leave the tampon there for so long, and again, like I said, with the blood there creates the environment over time where you can develop this very serious condition.

Touseef Mirza:
What are the first signs of staph?

Dr. Sophia:
Fever, shills, pain that comes to you pretty quick and it actually happens. You can go from being totally fine to totally not fine within 12-24 to 48 hours. And so if a woman, if you know that she was on her menses, someone who gets really, really sick fever, chills, pain, GI symptoms like nausea, vomiting, diarrhea, and develops a rash also can happen in toxic shock. Then there's a thought process that needs to be, could there potentially be a, a stuck tampon? A tampon that's been there for too long and that kind of thing. Now granted, I don't wanna be an alarmist , the vast majority of women who use tampons are not gonna get this. Right. And even though I've, I've just told you, I've had women who have come to see me even days later because they're coming for something that's routine or they feel like, oh, I'm having a little bit of a smell.
I don't know what it is, only to find out that they had a tampon that they didn't remember or didn't think about that was left inside and they were not sick.

They did not get toxic shock. So I don't want to make it seem as if, oh my God, this is exactly why no one should ever use a tampon. You know, but it's definitely a part of why we have tampon taboo. . Right. It's the fact that it could be considered as unsafe. Now, I do wanna mention the fact that toxic shock syndrome can happen, having nothing to do with a tampon and having nothing to do with menses at all. Because like I said, it's typically caused by staph. and it's the staph that releases a toxin and staph is all over our bodies. It's on our skin, it's in our noses, it's in our mouths. It's, it's everywhere. And so it's just a matter of the staph being allowed to overgrow in a specific area of the body that can then lead to toxin release and then cause toxic shock.

Touseef Mirza:
I think there's more awareness now of toxic shock. I feel like in the past when I was growing up, that wasn't really something that I knew about.

Dr. Sophia:
I definitely think there's more awareness because the numbers of, you know, it's certainly around menses or, or the concept of menstrual toxic shock. That number has decreased pretty dramatically of, of women presenting with that because of that.

Touseef Mirza:
We're not saying that we're pro tampon or against tampon. We're just saying that tampon is, is one option. It

Dr. Sophia:
It exists. Yeah. It exists. It's not something to be fearful of. Right. I think really what we're seeing is that there's so many things that women have to think about and especially around their period and just do the thing that's more comfortable for you. So the point of the matter is to know your body, know what's good for you, what's good and appropriate at the time. And that a tampon is, is an option.

Touseef Mirza:
It's okay.

Dr. Sophia:
It's okay.

Touseef Mirza:
Yeah. Hopefully we have dismantled some of the taboos so that people can make decisions that are really like, focused on them in terms of what's work, what works specifically for them.

Dr. Sophia:
Definitely. so actually I just wanna, before we close, give a few statistics which are pretty interesting. menstrual products that are used in the United States. So 50 to 60% of women use pads. 30 to 40% of women use tampons. five to 10% of women use menstrual cups. And now something I had did, did not exist when I was getting my period, something called period underwear. Five to 10% of women use those and reusable cloth pads. I'm sure this is the thing that my mom and my grandma probably used at some point in their lives. But the concept of reusable cloths, one to 5% of women use those.

And so, again, just letting you know you have options. There are things that we can use during our periods that are convenient and in line with us and our bodies. So in closing, I actually wanted to, read an excerpt from a poem written by Tenaya Jill Mill, and it's called Nothing Bloody Men Joke about it, even when women feel ashamed. But one thing is clear, there is nothing profane or to be blamed. Be proud of your blood cycle. Talk about it freely.

Touseef Mirza:
I hope that's what we did today.

Dr. Sophia:
I hope that's what we did today. We talked freely.

Until next time, thank you for joining us on the Dr. Sophia podcast. This is General Medical Information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.